scholarly journals Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis

2020 ◽  
Vol 2020 ◽  
Author(s):  
Anna Popławska-Kita ◽  
Marta Wielogórska ◽  
Łukasz Poplawski ◽  
Katarzyna Siewko ◽  
Agnieszka Adamska ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Pituitary Gland ◽  
Planning Process ◽  
Sella Turcica ◽  
Endocrine System ◽  
List Type ◽  
Papillary Thyroid ◽  
Postmortem Diagnosis ◽  
Atypical Metastasis

Summary Papillary thyroid gland carcinoma is the most common type of malignancy of the endocrine system. Metastases to the pituitary gland have been described as a complication of papillary thyroid cancer in few reported cases since 1965. We report the case of a 68-year-old female patient with a well-differentiated form of thyroid gland cancer. Despite it being the most common malignant cancer of the endocrine system, with its papillary form being one of the two most frequently diagnosed thyroid cancers, the case we present is extremely rare. Sudden cardiac arrest during ventricular fibrillation occurred during hospitalization. Autopsy of the patient revealed papillary carcinoma of the thyroid, follicular variant, with metastasis to the sella turcica, and concomitant sarcoidosis of heart, lung, and mediastinal and hilar lymph nodes. Not only does atypical metastasis make our patient’s case most remarkable, but also the postmortem diagnosis of sarcoidosis makes her case particularly unusual. Learning points: The goal of presenting this case is to raise awareness of the clinical heterogeneity of papillary cancer and promote early diagnosis of unexpected metastasis and coexisting diseases to improve clinical outcomes. Clinicians must be skeptical. They should not fall into the trap of diagnostic momentum or accept diagnostic labels at face value. Regardless of the potential mechanisms, clinicians should be aware of the possibility of the coexistence of thyroid cancer and sarcoidosis as a differential diagnosis of lymphadenopathy. This case highlights the importance of the diagnostic and therapeutic planning process and raises awareness of the fact that one uncommon disease could be masked by another extremely rare disorder.

The Endocrine System: Pituitary Gland

2017 ◽  
Author(s):  
Omer Doron ◽  
Jose E Cohen ◽  
Iddo Paldor
Keyword(s):  
Pituitary Gland ◽  
Human Body ◽  
Sella Turcica ◽  
Endocrine System ◽  
Portal System ◽  
Balance Growth ◽  
Sexual Drive ◽  
Pituitary Dysfunction ◽  
Physiologic Function ◽  
And Function

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function. This review contains 3 figures, and 38 references, Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica

scholarly journals Microcalcifications without a thyroid nodule as the sole sign of papillary thyroid carcinoma

2021 ◽  
Vol 2021 ◽  
Author(s):  
Stamatina Ioakim ◽  
Vasilis Constantinides ◽  
Meropi Toumba ◽  
Theodoros Lyssiotis ◽  
Angelos Kyriacou
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
List Type ◽  
Papillary Thyroid ◽  
Resected Tissue ◽  
Current Guidelines

Summary Our objective is to demonstrate the importance of considering microcalcifications even without evidence of nodules as a potential sign of malignancy. Current guidelines, such as those of the British Thyroid Association, acknowledge the clinical significance of microcalcifications only when found within nodules. In this case, they are considered a suspicious feature, classifying the nodules as U5 (i.e. high risk) where fine-needle aspiration biopsy (FNAB) is warranted, following the high likelihood of cancer in these nodules. In addition, there is a dearth of evidence of ultrasound scan (USS) detection of microcalcifications in the thyroid gland outside of nodules, along with their associated clinical implications. Yet, this clinical manifestation is not so infrequent considering that we do encounter patients in the clinic showing these findings upon ultrasound examination. Three patients who presented to our clinic with thyroid-related symptoms were shown to have areas of microcalcifications without a nodule upon sonographic evaluation of their thyroid gland. These incidentally detected hyperechoic foci were later confirmed to correspond to areas of papillary thyroid carcinoma (PTC) on histopathological examination of resected tissue following thyroidectomy. Four more cases were identified with sonographic evidence of microcalcifications without nodules and given their clinical and other sonographic characteristics were managed with active surveillance instead. Learning points Echogenic foci known as microcalcifications may be visible without apparent association to nodular structures. Microcalcifications without nodules may not be an infrequent finding. Microcalcifications are frequently indicative of malignancy within the thyroid gland even without a clearly delineated nodule. Empirically, the usual guidelines for the management of thyroid nodules can be applied to the management of microcalcifications not confined to a nodule, but such a finding per se should be classified as a ‘high-risk’ sign.

The Endocrine System: Pituitary Gland

2017 ◽  
Author(s):  
Omer Doron ◽  
Jose E Cohen ◽  
Iddo Paldor
Keyword(s):  
Pituitary Gland ◽  
Human Body ◽  
Sella Turcica ◽  
Endocrine System ◽  
Portal System ◽  
Balance Growth ◽  
Sexual Drive ◽  
Pituitary Dysfunction ◽  
Physiologic Function ◽  
And Function

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function. This review contains 3 figures, and 38 references, Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica

scholarly journals Warthin-Like Papillary Carcinoma of the Thyroid Gland: Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Panagiotis Paliogiannis ◽  
Federico Attene ◽  
Federica Trogu ◽  
Mario Trignano
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Histopathological Examination ◽  
Lymph Node Involvement ◽  
Papillary Thyroid ◽  
Review Of The Literature

We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.

scholarly journals MON-455 Papillary Thyroid Carcinoma in the Thyroglossal Duct

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Katty Manrique Franco ◽  
Helard Andres Manrique ◽  
William Lapa Yauri ◽  
José Solis Villanueva
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Hyoid Bone ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Thyroglossal Duct ◽  
Group Iii ◽  
Total Body

Abstract BACKGROUND In the thyroglossal duct (TD) there are remains of thyroid tissue in 1-40%. Thyroid cancer diagnosed in this duct is an uncommon finding, with a prevalence of less 1% and must meet these criteria: identify the TD, locate remains of carcinoma in it; absence of cancer in the thyroid gland and presence of thyroid follicles in the TD. We present a patient with thyroid cancer in the TD. CLINICAL CASE 63-years-old-woman. 18 months ago, she noted a submandibular tumor associated to asthenia, weight loss and tremor. On physical examination: 3cm tumor, increased consistency, near to the hyoid bone and 1.5cm left cervical adenopathy. Blood analysis: TSH 0.01 (0.2-4.5) and FT4 5.53 (0.9-1.7). Hyperthyroidism was diagnosed and she started Tiamazol 10mg/bid and propanolol 20mg/tid. Thyroid US: diffuse goiter. Soft tissue US: heterogeneous mass 39x15x26mm in midline of suprathyroid region suggestive of neoformative process. Cervical CT scan: solid, heterogeneous, neoformative tissue, located in the midline, infiltrating prelaringeal muscles in contact with hyoid bone. Cervical adenopathy in group II on right side and group III and IV on the left side. Increase in thyroid gland volume. FNA US guided of suprathyroid tumor was performed: cytology compatible with papillary thyroid carcinoma, Bethesda VI. FNA left adenopathy: compatible with metastasis papillary carcinoma. Midline tumor exeresis in relation to a TD (Sistrunk surgery), total thyroidectomy plus left lymph node dissection group IIA, IIB, III, IV and V was performed. Surgical findings: Right lobe thyroid 4x3x2cm with 1cm nodule on the upper pole. Left thyroid lobe 6x4x2cm with multiple nodules, the largest one in upper pole, 2cm. Multiple adenopathies. A 3x3x1cm tumor with irregular edges, hard consistency, adhered to the hyoid bone was removed. The histology was compatible with papillary thyroid carcinoma in the TD. Thyroid gland was informed as simple goiter. 150ug of levothyroxine was initiated. Six months later, she receives 100mCi I131. The total body scan was positive for thyroid remnant in cervical region. TSH 0.8 FT4 1.71. Thyroglobulin (TG) 13.98 and AntiTG 400. One year later, new total body scan was negative. TG 10,3 and antiTG 816. New thyroid US showed group III cervical adenopathy 4x7x3mm. Biopsy was compatible with metastasis of papillary thyroid carcinoma. The patient is awaiting a new surgery for lymph node dissection. CONCLUSION Sistrunk surgery and total thyroidectomy plus lymphadenectomy should be the treatment of choice in thyroid cancer in TD, followed by ablative therapy. This attitude improves long-term follow-up and reduces the risk of recurrence. BIBLIOGRAPHY 1. Granado A, et al. Cáncer del conducto tirogloso. Acta Chir Catal, 8 (1987), 37-44 2. Echenique E. Thyroid cancer arising in a thyroglossal duct cyst. Cir Esp. 2000 67 (6) 567-71.

Psoriasis and the endocrine system

1930 ◽  
Vol 26 (9) ◽  
pp. 942-943
Author(s):  
W. Schmidt
Keyword(s):  
Thyroid Gland ◽  
Pituitary Gland ◽  
Adrenal Glands ◽  
Endocrine System ◽  
Endocrine Glands

Abstracts. Venereology and Dermatology. Psoriasis and the endocrine system. W. Schmidt. (Derm. Ztschr.Bd. 57r H. 5) gives a picture dependence of pooriasisa on the endocrine glands; the data of roentgenograms obtained in the study of hypophys, data concerning the treatment of scaly lichen with extracts from the ovaries, thyroid gland, thymus and adrenal glands are given. The author examined 23 patients and found that the pituitary gland was normal in 9 persons, shields, gland in 3, thymus in 19, sexes, glands in 14, adrenal glands in 17, and the rest was marked by fluctuations in functions in one direction or another. ... Deviations from the norm are especially striking on the side of the thyroid gland and pituitary gland.

Concomitant occurrence of papillary thyroid cancer (PTC) in a branchial cleft cyst (BCC) and an occult multifocal PTC in the thyroid gland

2017 ◽  
Author(s):  
Ewelina Szczepanek-Parulska ◽  
Martyna Borowczyk ◽  
Alina Kluk ◽  
Grzegorz Dworacki ◽  
Marcin Orłowski ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Branchial Cleft Cyst ◽  
Branchial Cleft

VAIKŲ SKYDLIAUKĖS VĖŽYS PO PERSIRGTOS ONKOLOGINĖS LIGOS

2015 ◽  
Vol 21 (2.1) ◽  
pp. 110-116
Author(s):  
Ingrida Albužytė ◽  
Gražina Lingė ◽  
Gražina Mickunaitienė ◽  
Gražina Kleinotienė ◽  
Jelena Rascon
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Old Age ◽  
Age Group ◽  
Papillary Thyroid ◽  
Thyroid Malignancy ◽  
Follicular Thyroid Cancer ◽  
Carcinogenic Effect ◽  
Pediatric Malignancy

Thyroid cancer is a rare disease in children. Approximately 5 to 6 children in Lithuania are diagnosed thyroid malignancy each year. According to Thyroid Cancer Survivors‘ Association papillary and follicular thyroid cancer accounts approximately for only 1 percent of all paediatric cancers in the 5–9 year old age group and up to 7 percent of cancers in 15–19 year old age group. Thyroid gland in children is more sensitive to the carcinogenic effect of ionizing radiation than in adults. Damage to the thyroid gland after the first paediatric malignancy is usually the result of radiation to the head or neck area. Regular follow-up after the first oncological disease is essential to identify thyroid lesions early so that the proper treatment can be initiated. Fortunately, the prognosis is excellent for the most cases of paediatric thyroid cancer, even if there is metastatic disease at diagnosis. In this article we aimed to review pathogenesis, risk factors and prognosis of the second thyroid cancer following cure for the first pediatric malignancy. We report also a clinical case of papillary thyroid carcinoma diagnosed in a young patient following 13 years after being treated for nephroblastoma.

Extensive and Concurrent Infiltration of an Ectopic Intrathoracic Thyroid and Thyroid Gland by Papillary Thyroid Cancer

2010 ◽  
Vol 76 (9) ◽  
pp. 152-153
Author(s):  
George H. Sakorafas ◽  
Christos Lappas ◽  
Aikaterini Mastoraki ◽  
Olympia Kotsilianou ◽  
Polyzois Makras ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid

scholarly journals A case of thyroid fibromatosis, a rare lesion of this gland

2016 ◽  
Vol 2016 ◽  
Author(s):  
Joana Simões-Pereira ◽  
Rafael Adame Cabrera ◽  
Valeriano Leite
Keyword(s):  
Cell Proliferation ◽  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Spindle Cell ◽  
List Type ◽  
Beta Catenin ◽  
Papillary Thyroid ◽  
Thyroid Cells ◽  
Spindle Cell Proliferation ◽  
Rare Lesion

Summary Thyroid fibromatosis is a very rare lesion; to our knowledge, there are only four cases reported in the medical literature. Herein, we report the clinical case of a woman with thyroid fibromatosis with a long follow-up (11 years). A 63-year-old female patient, with an increasing multinodular goitre without compressive symptoms, was admitted to total thyroidectomy. The histology revealed a spindle-cell proliferation with fibroblastic characteristics with no atypia and thin capillary vessels. Immunohistochemistry was positive for beta-catenin, focally to desmin and alfa-actin and negative for cytokeratins and CD34. Thyroid cells did not display any features of papillary thyroid cancer. These characteristics were compatible with thyroid fibromatosis. For the past 11 years, the patient has been periodically followed up with neck CTs and she has not shown any signs of recurrence. Thyroid fibromatosis has been associated with invasion of surrounding structures in previous reported cases. However, this aggressive behaviour was not observed in our patient. The most challenging differential diagnosis is with papillary thyroid cancer with fibromatosis-like stroma, in which the malignant component is usually peripheral. Therefore, in these cases, it is mandatory to perform an extensive examination of the resected sample. Learning points: Fibromatosis is a mesenchymal lesion that consists of an infiltrative proliferation of fibroblasts without atypia. Thyroid fibromatosis is a rare entity in this gland. In previously reported cases, it has been associated with an invasive behaviour but this was not the case in our patient. When spindle-cell proliferation with fibroblastic/myofibroblastic characteristics is detected on thyroid histology, it is mandatory to exclude a papillary thyroid carcinoma with fibromatosis-like stroma.

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